Leukemias and Myeloid Disoders Summary

Question 1

ALL age, sex, epidem

Answer 1

Childhood and adolesnce
M>F
80% of acute leuk in children…more in white

Question 2

ALL clinical, morpho, cell markers

Answer 2

Paid onset, if precurosr T type then LAD, mediastinal mass
Bone pain, CNS, and testes

Convoluted to round, small to medium sied blasts

95% TdT…precursor B=85%, T=15%

Question 3

AML age, sex, epidem

Answer 3

Any age…more adults
More Male
80-90% acute leukemia in adults

Question 4

AML clinical, morpho, cell markers

Answer 4

Rapid onset with gum hyperplasia in monocytic, DIC in promyelocytic

Several types…auer rods can help diagnosse

MPO in myeloid
Esterase in monocytic

CD13,15,33 - myeloid
CD34,117 - immaturity

Question 5

CML age, sex, epi

Answer 5

25-60
Slight M>F
Mostly adultss

Question 6

CML clinical morpho cell markers

Answer 6

Gradual onset with splenomegality, bleeding and infections occur later

Chronic stage - all stages myeloid…blast phase - myeloid, lymphoid mixed

Myeloid markers in chronic phase…lymphoid blast crisis normally TfT and CD19 positive

Question 7

CLL age, sex, epi

Answer 7

90%>50
More male
Common in western, not asain

Question 8

CLL clinical, morpho, cell markers

Answer 8

Gradual onset
Increased infections
LAD or hepatosplenomegaly maybe

Small mature lymphocytes in blood and marrow

Clonal mature B cells express CD5 and CD23

Question 9

HCL age, sex, epi

Answer 9

80%>40
More Male
2% of leukemias

Question 10

HCL clinical, morpho, cell marker

Answer 10

Gradual
Bacterial, myco infection
Splenomegaly and pancytopenia

Hairy cells in blood marrow and spleen, dry tap

Clonal marure B cells with CD19, 29, 103, 25, and 11c

Question 11

ALL blood counts, prognosis and other

Answer 11

60% increased WBC, anemia, thrombocytopenia

95% children enter emission

Good prognosis is age 2-10 with low WBC, hyperdiploidy, trisomy 4,7,10 or t:12;21)

Bad if t(9;22) or MLL

Question 12

AML blood counts, labs

Answer 12

Half have increased WBC, some anemia and thrombocytpenia

DIC…decreased fibrinogen in promyelocytic

Question 13

AML prognosis and misc

Answer 13

60% enter remission but most relapse

Cytogenics important
Favorable - t(8;21) and t(15;17) and 16 abnormatlities

Unfav - AML with myelodysplasia, therapy related AML, FLT3

Question 14

CML blood counts nad labs

Answer 14

WBC>20,000
Basophilia with anemia and eosinophila
50% have thrombocytosis

Ph1 in 90-05%

Question 15

CLL blood counts and labs

Answer 15

Blood>4,000 lymps
+- anemic and thrombcytopenic
IMmune cytopenias
Hypogammaglobulinemiain 50%

Question 16

HCL blood counts and labs

Answer 16

Pancytopneia in more than 50%
Neutropenia in 90%
Anemia in 80%
Monocytopenia in 90-100

Occassional monoclonal gammopathy